Clinical effectiveness and safety of self-expanding metal stent placement following palliative chemotherapy in patients with advanced esophageal cancer

2019 ◽  
Vol 45 (2) ◽  
pp. 563-570 ◽  
Author(s):  
Nader Bakheet ◽  
Hong-Tao Hu ◽  
Jung-Hoon Park ◽  
Jae Yong Jeon ◽  
Sung Hwan Yoon ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Stent Placement ◽  
Palliative Chemotherapy ◽  
Clinical Effectiveness ◽  
Advanced Esophageal Cancer ◽  
Metal Stent

scholarly journals Assesment of placement of the esophageal self-expandable metallic stent in esophageal cancer in patients with or without citorreduction therapy

2007 ◽  
Vol 20 (3) ◽  
pp. 154-160
Author(s):  
Gilson Kamiyama ◽  
Paulo Sakai ◽  
Eduardo Guimarães H. de Moura ◽  
Shinichi Ishioka ◽  
Ivan Cecconello ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Time ◽  
Stent Placement ◽  
Gastrointestinal Endoscopy ◽  
Thoracic Esophagus ◽  
Metallic Stent ◽  
Advanced Esophageal Cancer ◽  
Expandable Metallic Stent ◽  
Stent Treatment ◽  
Time Average

BACKGROUND: Placement of self-expanding metallic esophageal stent in patients with advanced esophageal cancer offers excellent palliation of dysphagia and tracheo-esophageal fistulas. However, the safety of stent in patients undergoing radio and/or chemotherapy is controversial, in terms of the greater risk of complications in cases where these two treatments are used in conjunction. AIM: To assess the use of stent in patients with advanced cancer of the mid-thoracic esophagus, by comparing patients undergoing cytoreductive therapy with patients who have not undergone this treatment, in relation to improvement in the dysphagia, rate of complications, period of effectiveness and survival time. METHODS: Fifty seven patients were evaluated retrospectively (16 women and 41 men, with an average age 62 years) with advanced squamous cell carcinoma of the mid-thoracic esophagus who underwent placement of the Ultraflex™ self-expandable metallic coated stent, at the Gastrointestinal Endoscopy Unit of São Paulo University Medical School between October 1988 and October 2004. Out of the 57 patients, 24 patients received adjuvant cytoreductive therapy, and 33 patients were only treated with the stent placement. RESULTS: After stent placement, there was improvement in dysphagia in both groups; there were no differences in the rate of complications, such as migration, pain, fistula, obstruction and compression of the airways; the period of effectiveness was significantly higher in the group submitted to cytoreductive therapy (average 123 days compared to 63 days), as was the survival time (average of 210 days, compared with 120 days). CONCLUSIONS: Improvement in dysphagia was statistically significant in both groups, irrespective of whether the patient had undergone adjuvant cytoreductive therapy; there were no differences in the rate of complications between the two groups and both the period of effectiveness of the stent treatment and the survival time were higher in the group with adjuvant cytoreductive therapy.

Stenting for Advanced Esophageal Carcinoma

2018 ◽  
Vol 02 (01) ◽  
pp. 018-024
Author(s):  
Kun Kim ◽  
Jung-Hoon Park ◽  
Ji Shin
Keyword(s):  
Esophageal Cancer ◽  
Esophageal Carcinoma ◽  
Surgical Resection ◽  
Stent Placement ◽  
Advanced Stage ◽  
Advanced Esophageal Cancer ◽  
Sems Placement ◽  
Rigid Plastic ◽  
Expandable Metallic Stents ◽  
Common Malignancy

AbstractEsophageal cancer is the eighth most common malignancy and the sixth leading cause of cancer-related deaths worldwide. Most patients with esophageal cancer are identified at an advanced stage of disease. Less than 20% of patients are candidates for curable surgical resection. Self-expandable metallic stents (SEMSs) have recently been used for the palliation of incurable esophageal cancer. Since their use was first reported in the late 1970s, stents have evolved rapidly from rigid plastic tubes to flexible SEMSs. This review covers various aspects of SEMS placement for advanced esophageal cancer and discusses multiple types of SEMSs, considerations in stent placement, complications, and recently developed radiation-emitting stents.

Biodegradable stent placement before neoadjuvant chemoradiotherapy as a bridge to surgery in patients with locally advanced esophageal cancer

2014 ◽  
Vol 80 (5) ◽  
pp. 908-913 ◽  
Author(s):  
Maarten W. van den Berg ◽  
Daisy Walter ◽  
Elisabeth M.G. de Vries ◽  
Frank P. Vleggaar ◽  
Mark I. van Berge Henegouwen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Stent Placement ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Bridge To Surgery ◽  
Advanced Esophageal Cancer ◽  
Biodegradable Stent ◽  
Locally Advanced Esophageal Cancer

Anesthetic Approach for Endoscopic Repair of Acquired Tracheoesophageal Fistula

2017 ◽  
Vol 21 (4) ◽  
pp. 357-359 ◽  
Author(s):  
Sina Ghaffaripour ◽  
Fouad G. Souki ◽  
Kianfa Martinez-Lu ◽  
Gisele Wakim
Keyword(s):  
Esophageal Cancer ◽  
Stent Placement ◽  
Tracheoesophageal Fistula ◽  
Stent Migration ◽  
Esophageal Stent ◽  
Medical Attention ◽  
Metal Stent ◽  
Endoscopic Repair ◽  
Anesthetic Care

Tracheoesophageal fistula develops in 5 % to 15 % of patients with esophageal cancer. Metal stent placement can be used for treatment. Stent placement can result in aspiration, hemorrhage, perforation, migration, and pneumonia. Patients may present for medical attention with unanticipated worsening of the fistula and stent displacement requiring special anesthetic care. We discuss the perianesthetic management of a patient with malignant tracheoesophageal fistula and stent migration who presented for endoscopic esophageal stent replacement.

Helical tomotherapy for advanced esophageal cancer improves target conformity and homogeneity: A comparison with fixed-field intensity-modulated radiotherapy

2015 ◽  
Vol 11 (3) ◽  
pp. 3146-3155
Author(s):  
Luhua Wang
Keyword(s):  
Esophageal Cancer ◽  
Field Intensity ◽  
Helical Tomotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Matched Pair ◽  
Conformity Index ◽  
Target Coverage ◽  
Advanced Esophageal Cancer ◽  
Fixed Field ◽  
Intensity Modulated

Purpose: To evaluate the usefulness of helical tomotherapy (HT) in the treatment of advanced esophageal cancer (EC) and compare target homogeneity, conformity and normal tissue doses between HT and fixed-field intensity-modulated radiotherapy (ff-IMRT).Methods: In all, 23 patients with cT3-4N0-1M0-1a thoracic EC (upper esophagus, 9 patients; middle esophagus, 6; distal esophagus, 6 and esophagogastric junction, 2) who were treated with ff-IMRT (60 Gy in 30 fractions) were re-planned for HT and ff-IMRT with the same clinical require­ments. Comparisons were performed using the Wilcoxon matched-pair signed-rank test.Results: Compared with ff-IMRT, HT significantly reduced the homogeneity index for thoracic, upper, middle and distal ECs by 38%, 31%, 36% and 33%, respectively (P < 0.05). The conformity index was increased by HT for thoracic, upper and middle ECs by 9%, 9% and 18%, respectively (P < 0.05). Target coverage was improved by 1% with HT (P < 0.05). The mean lung dose was significantly reduced by HT for thoracic and upper ECs (P < 0.05). The V20 (volume receiving at least 20 Gy) and higher dose volumes of the lungs were decreased by HT in all cases, but the differences were significant for thoracic, upper and distal ECs (P < 0.05), with reductions of 2.1%, 3.1% and 2.2%, respectively. HT resulted in a larger lung V5 for thoracic, upper, middle and distal ECs, with increases of 3.5%, 1.5%, 7.2% and 3.2%, respectively. Heart sparing was significantly better with HT than with ff-IMRT in terms of the V30 and V40 for thoracic, upper, middle and distal ECs (P < 0.05).Conclusions: Compared to ff-IMRT, HT provides superior target coverage, conformity and homogeneity, with reduced the volume of high doses to the lungs and heart for advanced EC. HT may be a treatment option for advanced EC, especially upper EC.

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